Brain tumor headache
- Christine L Lay, MD, FRCPC
Christine L Lay, MD, FRCPC
- Associate Professor
- Women's College Hospital
- Christina Sun-Edelstein, MD
Christina Sun-Edelstein, MD
- Department of Clinical Neurosciences
- St. Vincent's Hospital
Headache is one of the most common complaints encountered in clinical medicine. Though the vast majority of headaches are caused by primary headache disorders, more ominous etiologies, such as cerebral neoplasm or metastatic disease, may also be heralded by headache. This topic will review headache related to brain tumors. Other clinical aspects of brain neoplasms are discussed separately. (See "Overview of the clinical features and diagnosis of brain tumors in adults" and "Risk factors for brain tumors".)
The approach to evaluating headache in adults and children is reviewed elsewhere. (See "Evaluation of headache in adults" and "Headache in children: Approach to evaluation and general management strategies" and "Evaluation of the adult with headache in the emergency department" and "Emergent evaluation of headache in children".)
MECHANISMS OF HEADACHE
Traction on the large blood vessels and dura as well as direct compression of cranial and cervical nerve fibers by the tumor itself are the likely mechanisms for headaches attributed to brain tumors [1-3]. Of note, the brain parenchyma is insensitive to pain. Structures that are sensitive to pain include the following [2,3]:
●The large arteries at the base of the brain and the first few centimeters of their immediate branches
●The meningeal arteries
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